Surgical access device including anchor with rachet mechanism

ABSTRACT

A surgical access device includes a cannula body and an anchor. The cannula body includes a housing, and an elongated portion extending distally from the housing. The elongated portion defines a longitudinal axis and defines a channel extending therethrough. The anchor is disposed in mechanical cooperation with the elongated portion of the cannula body and is longitudinally translatable relative to the elongated portion. The anchor defines an aperture and includes a ratchet mechanism configured to selectively lock a size of the aperture.

BACKGROUND Technical Field

The present disclosure relates to a surgical access device. Moreparticularly, the present disclosure relates to a surgical access deviceincluding an anchor with a ratchet mechanism to help maintain itsposition relative to a patient during a surgical procedure.

Background of Related Art

In minimally invasive surgical procedures, including endoscopic andlaparoscopic surgeries, a surgical access device permits theintroduction of a variety of surgical instruments into a body cavity oropening. A surgical access device (e.g., a cannula) is introducedthrough an opening in tissue (i.e. a naturally occurring orifice or anincision) to provide access to an underlying surgical site in the body.The incision is typically made using an obturator having a blunt orsharp tip that has been inserted within the passageway of the surgicalaccess device. For example, a cannula has a tube of rigid material witha thin wall construction, through which an obturator may be passed. Theobturator is utilized to penetrate a body wall, such as an abdominalwall, or to introduce the surgical access device through the body wall,and is then removed to permit introduction of surgical instrumentationthrough the surgical access device to perform the surgical procedure.

During these procedures, it may be challenging to maintain the positionof the surgical access device with respect to the body wall,particularly when exposed to a pressurized environment. To help maintainthe position of the surgical access device with respect to the bodywall, an anchor positioned near a distal end of the surgical accessdevice and adjacent tissue is occasionally used. Positioning andsecuring such an anchor while the surgical access device is within thebody helps minimize undesired movement of the surgical access devicewith respect to the body.

Accordingly, it may be helpful to provide an anchor with a ratchetmechanism to help maintain the longitudinal position of the surgicalaccess device with respect to the patient.

SUMMARY

The present disclosure relates to a surgical access device including acannula body and an anchor. The cannula body includes a housing and anelongated portion extending distally from the housing. The elongatedportion defines a longitudinal axis and defines a channel extendingtherethrough. The anchor is disposed in mechanical cooperation with theelongated portion of the cannula body and is longitudinally translatablerelative to the elongated portion. The anchor defines an aperture andincludes a ratchet mechanism configured to selectively lock a size ofthe aperture.

In aspects, the ratchet mechanism of the anchor includes a C-shapedclip. The clip may include a first arcuate section and a second arcuatesection, where the first arcuate section is movable relative to thesecond arcuate section.

In aspects, the ratchet mechanism of the anchor includes a clip and ahandle, and the handle is pivotable relative to the clip. The ratchetmechanism may include a plurality of teeth disposed on at least one ofthe first arcuate section of the clip or the second arcuate section ofthe clip. Movement of the first arcuate section relative to the secondarcuate section may change the size of the aperture defined by theanchor. The ratchet mechanism may include a plurality of teeth disposedon the handle of the clip configured to engage the plurality of teeth ofthe at least one of the first arcuate section of the clip or the secondarcuate section of the clip. The handle may include a tab configured tofacilitate disengagement of the plurality of teeth of the handle fromthe plurality of teeth of the at least one of the first arcuate sectionof the clip or the second arcuate section of the clip.

In additional aspects, the anchor may include a sleeve radiallysurrounding at least a portion of the clip. The sleeve may be made fromfoam, gel, or rubber.

The present disclosure also relates to an anchor for use with a surgicalaccess device. The anchor defines an aperture and includes a C-shapedclip, and a handle. The C-shaped clip includes a first arcuate section,a section arcuate section and a backspan interconnecting the firstarcuate section and the second arcuate section. The first arcuatesection is movable relative to the second arcuate section to change asize of the aperture. At least one of the first arcuate section or thesecond arcuate section includes a plurality of teeth. The handle ispivotably engaged with the first arcuate section of the C-shaped clip.The handle includes a plurality of teeth configured to engage theplurality of teeth of the at least one of the first arcuate section orthe second arcuate section of the C-shaped clip to selectively lock aposition of the first arcuate section relative to the second arcuatesection.

In aspects, the handle may include a tab configured to facilitatedisengagement of the plurality of teeth of the handle from the pluralityof teeth of the at least one of the first arcuate section of the clip orthe second arcuate section of the clip. The anchor may also include asleeve radially surrounding at least a portion of the C-shaped clip. Thesleeve may be made from foam, gel, or rubber.

DESCRIPTION OF THE DRAWINGS

Various aspects of the present disclosure are illustrated herein withreference to the accompanying drawings, wherein:

FIG. 1 is a perspective view of a surgical access device including ananchor in accordance with the present disclosure;

FIG. 2 is an assembly view of the surgical access device of FIG. 1;

FIGS. 3 and 4 are perspective views of a portion of the anchor of FIGS.1 and 2;

FIG. 5 is a side view of the surgical access device of FIGS. 1 and 2within tissue illustrating the anchor in a proximal position;

FIG. 6 is a top cross-sectional view of a portion of the surgical accessdevice taken along section line 6-6 in FIG. 5;

FIG. 7 is a side view of the surgical access device of FIGS. 1 and 2within tissue illustrating the anchor in a distal position;

FIG. 8 is a top cross-sectional view of a portion of the surgical accessdevice taken along section line 8-8 in FIG. 7;

FIG. 9 is an assembly view of a handle of the anchor according tovarious aspects; and

FIG. 10 is a perspective of the anchor including the handle of FIG. 9.

DETAILED DESCRIPTION

Aspects of the presently disclosed surgical access device will now bedescribed in detail with reference to the drawings wherein like numeralsdesignate identical or corresponding elements in each of the severalviews. As is common in the art, the term “proximal” refers to that partor component closer to the user or operator, i.e. surgeon or physician,while the term “distal” refers to that part or component farther awayfrom the user.

Generally, the surgical access device or cannula, often part of a trocarassembly, may be employed during surgery (e.g., laparoscopic surgery)and may, in various aspects, provide for the sealed access oflaparoscopic surgical instruments into an insufflated body cavity, suchas the abdominal cavity. The cannula is usable with an obturatorinsertable therethrough. The cannula and obturator are separatecomponents but are capable of being selectively connected together. Forexample, the obturator may be inserted into and through the cannulauntil the handle of the obturator engages, e.g., selectively locks into,a proximal housing of the cannula. In this initial position, the trocarassembly is employed to tunnel through an anatomical structure, e.g.,the abdominal wall, either by making a new passage through the structureor by passing through an existing opening through the structure. Oncethe trocar assembly has tunneled through the anatomical structure, theobturator is removed, leaving the cannula in place in the structure,e.g., in the incision created by the trocar assembly. The proximalhousing of the cannula may include seals or valves that prevent theescape of insufflation gases from the body cavity, while also allowingsurgical instruments to be inserted into the body cavity.

Additionally, the surgical access device of the present disclosureincludes an anchor including a ratchet mechanism configured to engagetissue to help maintain the cannula in its position relative to the bodyduring use.

FIGS. 1-10 illustrate a surgical access device according to the presentdisclosure. With initial reference to FIG. 1, the surgical access device10 includes a cannula body 100 and an anchor 200. The cannula body 100includes a proximal housing 120 at its proximal end, and includes anelongated portion 140 extending distally from the proximal housing 120.The elongated portion 140 defines a channel 150 (FIG. 2) extendingtherethrough, and defines a longitudinal axis “A-A.” An obturator (notshown) is insertable through the channel 150 and is engageable with theproximal housing 120, for instance.

The anchor 200 is positionable around the elongated portion 140 of thecannula body 100 such that such that the anchor 200 radially surrounds aportion of the elongated portion 140. More particularly, the anchor 200is longitudinally translatable along the elongated portion 140 between afirst position, where the anchor 200 is farther away from a distal tip142 of the elongated portion 140 (FIG. 5), and a second position,wherein the anchor 200 is closer to the distal tip 142 of the elongatedportion 140 (FIG. 7). Additionally, the anchor 200 is configured totranslate longitudinally along the elongated portion 140 of the cannulabody 100, and to releasably and selectively lock itself into a desiredlongitudinal position.

Referring to FIGS. 1 and 2, the engagement between the anchor 200 andthe cannula body 100 is shown. The anchor 200 includes a clip 220, ahandle 240, and a sleeve 260. The clip 220 of the anchor 200 defines anaperture 222, through which the elongated portion 140 of the cannulabody 100 is insertable.

FIGS. 3 and 4 illustrate further details of the clip 220 and the handle240. The clip 220 includes a first arcuate section 225 and a secondarcuate section 235, which together define the aperture 222. In aspects,the clip 220 may be C-shaped including an adjustable gap “G” definedbetween the first arcuate section 225 and the second arcuate section235. The first arcuate section 225 is movable relative to the secondarcuate section 235 (or vice versa) between a first orientation defininga first size aperture 222 a (FIGS. 3, 4 and 6) and a second orientationdefining a second size aperture 222 b (FIG. 8). The first size aperture222 a is larger than the second size aperture 222 b; the gap “G”corresponding to the first size aperture 222 a is larger than the gap“G” corresponding to the second size aperture 222 b. In the firstorientation, where the clip 220 defines a larger aperture 222 a, theanchor 200 is longitudinally translatable along the elongated portion140 of the cannula body 100. In the second orientation, where the clip220 defines a smaller aperture 222 b, the anchor 200 is fixed fromtranslating longitudinally along the elongated portion 140 of thecannula body 100. As discussed below, a ratchet mechanism 215 isincluded on the anchor 200 to selectively lock the size of the aperture222 defined by the anchor 200.

With continued reference to FIGS. 3 and 4, the handle 240 of the anchor200 is shown. The handle 240 is arcuate, is coupled to a portion of theclip 220, and is pivotable relative to the clip 220. In the aspectsshown in FIGS. 2-4, for instance, the handle 240 is integrally formedwith the clip 220 (e.g., molded as a part of the clip 220), and includesa living hinge therebetween.

In the aspects shown in FIGS. 9 and 10, for instance, a handle 240′connects to the clip 220 via a pin 243. In the illustrated aspects, thehandle 240′ is pivotably engaged with the first arcuate section 225 ofthe clip 220, although the handle may alternatively be engaged with adifferent portion of the clip 220 (e.g., the second arcuate section235). As discussed below, pivoting the handle 240′ relative to the clip220 moves the clip 220 between its first orientation and its secondorientation.

Referring now to FIGS. 3, 4, 6 and 8, further details of the clip 220and the handle 240 of the anchor 200 are shown. The first arcuatesection 225 and the second arcuate section 235 of the clip 220 eachextend from a common backspan 230. The first arcuate section 225 definesa free end 226, which is spaced from the backspan 230, and the secondarcuate section 235 defines a free end 236, which is spaced from thebackspan 230. Depending on the orientation of the clip 220, a gap “G” isdefined between the free end 226 of the first arcuate section 225 andthe free end 236 of the second arcuate section 235. As the clip 220moves from its first orientation to its second orientation, the gap “G”and the aperture 222 defined by the anchor 200 become smaller. Inaspects (e.g., depending on the diameter of the elongated portion 140 ofthe cannula body 100), the free end 226 of the first arcuate section 225is spaced from the free end 236 of the second arcuate section 235 whenthe clip 220 is in its second orientation. In other aspects, the freeend 226 of the first arcuate section 225 contacts the free end 236 ofthe second arcuate section 235 when the clip 220 is in its secondorientation. In yet other aspects, the free end 226 of the first arcuatesection 225 overlaps the free end 236 of the second arcuate section 235when the clip 220 is in its second orientation.

With continued reference to FIGS. 3, 4, 6 and 8, a ratchet mechanism 215is shown and is disposed on portions of the clip 220. The ratchetmechanism 215 selectively locks the size of the aperture 222 defined bythe anchor 200. The first arcuate section 225 of the clip 220 includesan upper portion 225 a and a lower portion 225 b, and the second arcuatesection 235 of the clip 220 includes an upper portion 235 a and a lowerportion 235 b (FIG. 4). The ratchet mechanism 215 is included on theupper portion 235 a of the second arcuate section 235 and on the handle240. More particularly, the ratchet mechanism 215 includes a pluralityof grooves or teeth 238 (i.e., one or more teeth) on the upper portion235 a of the second arcuate section 235, and a plurality of grooves orteeth 248 (i.e., one or more teeth) on the handle 240. The plurality ofteeth 238 of the second arcuate section 235 is configured to engage theplurality of teeth 248 of the handle 240 in a ratcheting manner. Inparticular, the plurality of teeth 238 of the second arcuate section 235and the plurality of teeth 248 of the handle 240 are angled such thatmovement of the handle 240 in a first direction (e.g., arrow “B” in FIG.8) relative to the second arcuate section 235 is facilitated, whilemovement of the handle 240 in a second, opposite direction (e.g., arrow“C” in FIG. 8) relative to the second arcuate section 235 is hindered orprevented. That is, the plurality of teeth 238 of the second arcuatesection 235 and the plurality of teeth 248 of the handle 240 areconfigured to facilitate incremental movement of the clip 220 from itsfirst orientation toward its second orientation, and effectively locksthe clip 220 in a desired position (e.g., when the clip 220 is tightaround the elongated portion 140 of the cannula body 100). Additionally,in various aspects, the first arcuate section 225 also includes aplurality of teeth that are configured to engage the plurality of teeth248 of the handle 240.

As shown in FIGS. 3, 4, 6 and 8-10, the handle 240 also includes a tab250 extending radially outwardly from an end of the handle 240. The tab250 is configured to be grasped by a user such that manipulation of thehandle 240 is facilitated. More particularly, a user can grasp or pressthe tab 250 of the handle 240 to move (e.g., pivot) the handle 240relative to the second arcuate section 235 of the clip 220, such as whenmoving the clip 220 from its first orientation toward its secondorientation. Additionally, a user can move the tab 250 away from thesecond arcuate section 235 of the clip 220 (in the general direction ofarrow “D” in FIG. 6) to effectively unlock the plurality of teeth 248 ofthe handle 240 from the plurality of teeth 238 of the second arcuatesection 235.

In various aspects, the tensile strength of the material of the handle240 helps the handle 240 remain engaged with the second arcuate section235. For instance, the handle 240 may be made from plastic or othersuitable materials.

As shown in FIGS. 3, 4, 6, 8 and 10, the clip 220 also includes arms251. The arms 251 are shown extending radially outward from a portion ofthe clip 220 adjacent the backspan 230. The arms 251 may be useful tograsp while longitudinally translating the anchor 200 along theelongated portion 140 of the cannula body 100. Additionally, each arm251 includes a finger 252 at an end thereof, and defines a notch 254.The fingers 252 and/or notches 254 can be used as locations to tiesutures to during use, for instance. In aspects, the clip 220 mayinclude more or fewer arms 251 than the two arms 251 that areillustrated. For instance, the clip 220 may not include any arms 251.

The sleeve 260 is shown in FIGS. 1, 2 and 5-8. The sleeve 260 radiallysurrounds the lower portions 225 b, 235 b of the first arcuate portion225 and the second arcuate portion 235, respectively, of the clip 220.In aspects, the sleeve 260 is secured to the clip 220 such that thesleeve 260 and the clip 220 cannot be moved independently of each other.The sleeve 260 is configured to radially expand and contract such thatthe sleeve 260 remains in contact with the first arcuate portion 225 andthe second arcuate portion 235 while the clip 220 transitions betweenits first and second orientations. Additionally, the sleeve 260 isconfigured to longitudinally compress in response to being moved againsta tissue wall “T,” for instance, as indicated by arrows “E” in FIG. 7.The sleeve 260 may be made from foam, gel, rubber (e.g., elastomers), orother suitable compressive material.

Additionally, as shown in FIGS. 1, 2, 5 and 7, the anchor 200 can beused in connection with an additional fixation mechanism 300. Forinstance, as shown in FIGS. 5 and 7, while the anchor 200 may bepositioned along the elongated portion 140 of the cannula body 100adjacent a proximal wall of tissue adjacent an incision, fixationmechanism 300 can radially extend from the elongated portion 140 of thecannula body 100 and be positioned adjacent a distal wall of the tissueadjacent the incision, for example.

In use, the anchor 200 is initially in a proximal position along theelongated portion 140 of the cannula body 100 as the distal end of thecannula body 100 is being inserted into and/or positioned within thetissue cavity “C” (FIGS. 5 and 7). Next, the fixation mechanism 300, ifincluded, is moved to expanded position (FIGS. 5 and 7), and the cannulabody 100 is moved proximally such that the fixation mechanism 300contacts the distal portion of the tissue wall “T,” for instance. Then,the anchor 200 is moved distally along the elongated portion 140 of thecannula body 100 such that the anchor 200 contacts a proximal portion ofthe tissue wall “T,” and the ratchet mechanism 215 is utilized todecrease and lock the size of the aperture 222 such that the anchor isfixed positioned on the elongated portion 140 of the cannula body 100.Here, the tissue wall “T” is sandwiched between the anchor 200 and thefixation mechanism 300 (FIG. 7), and the longitudinal position of thecannula body 100 is fixed relative to the tissue wall “T.”

While the above description contains many specifics, these specificsshould not be construed as limitations on the scope of the presentdisclosure, but merely as illustrations of various aspects thereof.Therefore, the above description should not be construed as limiting,but merely as exemplifications of various aspects. Those skilled in theart will envision other modifications within the scope and spirit of theclaims appended hereto.

What is claimed is:
 1. A surgical access device, comprising: a cannulabody including a housing and an elongated portion extending distallyfrom the housing, the elongated portion defining a longitudinal axis anddefining a channel extending through the elongated portion; an anchordisposed in mechanical cooperation with the elongated portion of thecannula body and being longitudinally translatable relative to theelongated portion, the anchor defining an aperture and including aratchet mechanism for selectively locking a size of the aperture; and asleeve radially surrounding at least a portion of the anchor.
 2. Thesurgical access device according to claim 1, wherein the ratchetmechanism of the anchor includes a C-shaped clip.
 3. The surgical accessdevice according to claim 2, wherein the clip includes a first arcuatesection and a second arcuate section, the first arcuate section beingmovable relative to the second arcuate section.
 4. The surgical accessdevice according to claim 2, wherein the sleeve radially surrounds atleast a portion of the C-shaped clip.
 5. The surgical access deviceaccording to claim 1, wherein the ratchet mechanism of the anchorincludes a clip and a handle, the handle being pivotable relative to theclip.
 6. The surgical access device according to claim 5, wherein theclip includes a first arcuate section and a second arcuate section, thefirst arcuate section being movable relative to the second arcuatesection.
 7. The surgical access device according to claim 6, wherein theratchet mechanism includes a plurality of teeth disposed on at least oneof the first arcuate section of the clip or the second arcuate sectionof the clip.
 8. The surgical access device according to claim 7, whereinthe ratchet mechanism includes a plurality of teeth disposed on thehandle of the clip for engaging the plurality of teeth of the at leastone of the first arcuate section of the clip or the second arcuatesection of the clip.
 9. The surgical access device according to claim 8,wherein the handle includes a tab for facilitating disengagement of theplurality of teeth of the handle from the plurality of teeth of the atleast one of the first arcuate section of the clip or the second arcuatesection of the clip.
 10. The surgical access device according to claim6, wherein movement of the first arcuate section relative to the secondarcuate section changes the size of the aperture defined by the anchor.11. The surgical access device according to claim 5, wherein the sleeveradially surrounds at least a portion of the clip.
 12. The surgicalaccess device according to claim 1, wherein the sleeve is made fromfoam, gel, or rubber.
 13. An anchor for use with a surgical accessdevice, the anchor defining an aperture and comprising: a C-shaped clipincluding a first arcuate section, a section arcuate section and abackspan interconnecting the first arcuate section and the secondarcuate section, the first arcuate section movable relative to thesecond arcuate section to change a size of the aperture, at least one ofthe first arcuate section or the second arcuate section including aplurality of teeth; and a handle pivotably engaged with the firstarcuate section of the C-shaped clip, the handle including a pluralityof teeth configured to engage the plurality of teeth of the at least oneof the first arcuate section or the second arcuate section of theC-shaped clip to selectively lock a position of the first arcuatesection relative to the second arcuate section.
 14. The anchor accordingto claim 13, wherein the handle includes a tab for facilitatingdisengagement of the plurality of teeth of the handle from the pluralityof teeth of the at least one of the first arcuate section of the clip orthe second arcuate section of the clip.
 15. The anchor according toclaim 13, further including a sleeve radially surrounding at least aportion of the C-shaped clip.
 16. The anchor according to claim 15,wherein the sleeve is made from foam, gel, or rubber.
 17. A surgicalaccess device, comprising: a cannula body including a housing and anelongated portion extending distally from the housing, the elongatedportion defining a longitudinal axis and defining a channel extendingthrough the elongated portion; and an anchor disposed in mechanicalcooperation with the elongated portion of the cannula body and beinglongitudinally translatable relative to the elongated portion, theanchor defining an aperture and including a ratchet mechanism forselectively locking a size of the aperture, the ratchet mechanismincluding a clip and a handle, the handle being pivotable relative tothe clip, and the clip including a first arcuate section and a secondarcuate section, the first arcuate section being movable relative to thesecond arcuate section.
 18. The surgical access device according toclaim 17, further including a sleeve radially surrounding at least aportion of the anchor.
 19. The surgical access device according to claim18, wherein the sleeve is made from at least one of foam, gel, orrubber.
 20. The surgical access device according to claim 17, whereinthe anchor includes a first arcuate section and a second arcuatesection, the first arcuate section being movable relative to the secondarcuate section.